http://viewchange.org Videos from ViewChange.org (Filtered by topics: Clinic) en-us Tue, 10 Jan 2012 10:22:00 +0000 Copyright 2011 Link Media, Inc. http://www.viewchange.org/videos/the-health-show-riders-for-health-2 Access is often the largest obstacle to healthcare. Nowhere is this more apparent than in the rugged, mountainous country of Lesotho, where much of the population lives mired in rural poverty. But one organization, Riders for Health, has introduced an all-terrain option that's linking communities in the most remote regions: the motorbike. Tue, 10 Jan 2012 10:22:00 +0000 http://www.viewchange.org/videos/the-health-show-riders-for-health-2 Lesotho, Health, Riders for Health, HIV, Africa, Sub-Saharan Africa, Healthcare, Rural area, Television, AIDS >> VOICEOVER: The mountain kingdom of Lesotho is a land of heights and extremes. The entire country stands more than 3,000 feet above sea level. The terrain and climate are harsh, and more than 75 percent of the population lives in rural areas. Delivering regular health care to those in the countryside is nearly impossible. But thanks to Riders for Health, a global non-profit, one vehicle is changing the game: the motorbike. It's rugged, it's durable, and it lets healthcare workers reach all their patients, no matter how remote. Challenges abound, but with a motorbike, distance is no longer such an obstacle. Join Rockhopper TV as it follows six people using these motorbikes to alter the terrain of healthcare delivery. >> TITLE: ViewChange >> TITLE: Riders for Health, Rockhopper TV, Lesotho >> VOICEOVER: The mountain kingdom of Lesotho in southern Africa. Here, most people live high in remote villages, far from tarred roads and beyond the reach of most vehicles. In winter, villages are often cut off altogether by snow. For most people, getting around here means walking. It's early morning, and yesterday's snow means a cold start for Thabiso Phoka. He's a nurse at Auray Health Center high in the mountains. >> THABISO PHOKA [Nurse, Auray Health Center]: I'm preparing the package for the outreach. There's a tally sheet inside and the needles as well for the immunizations. >> VOICEOVER: Today, Thabiso's getting ready to travel to the village of Hatakani to immunize babies and run an under five's clinic. It is ten kilometers away over rough ground - half a day's walk for most people - but Thabiso is lucky; he'll be going by motorbike. >> THABISO PHOKA: I always loved the idea of being a nurse because I wanted to help people in the community. The roads are really difficult, and it's tough riding when it's so cold. But now I know I can get wherever I need to without any problems. >> VOICEOVER: Thabiso's destination, Hatakani, is a very remote place. A simple lack of transport means people are often unable or reluctant to get medical help. For Thabiso, this meant diseases went untreated and children remained unvaccinated. But last year he was provided with a motorbike and trained how to ride it. But even for Thabiso, Hatakani is hard to reach, and he has to walk the final leg down to the village. >> THABISO PHOKA: Before the motorbike it was not easy to come. I think they were thinking that we were neglecting them. >> VOICEOVER: Thabiso comes here on a set day every month. Mothers from the village and surrounding area have brought their children for an under five's clinic. >> THABISO PHOKA: The most important things I do in the villages are vaccinations and giving health talks about how people should take care of themselves, because some of the illnesses they come to the health centers with are things they themselves should be able to prevent. The cases we used to see a lot were hygiene related, like diarrhea and scabies, but they're no longer here because we've taught people how to look after themselves. >> TITLE: ViewChange >> VOICEOVER: These new recruits are starting their second day of training. None of them have ever ridden a motorbike before. Isaac Monokwa, like the other trainees, works at a government-run rural health center. >> ISAAC MONOKWA [Ministry of Health, Lesotho]: I work as an HIV/AIDS counselor. My job at the clinic is to encourage people to check their status. I do the tests myself and if they test positive, I talk to them about the treatment they must follow. The motorbike will really help me. I'll be able to get around much quicker and will be able to get to more villages in a day. >> VOICEOVER: But when it comes to learning to ride, Isaac has a long way to go. It seems he'll be testing Soloman's teaching skills, and his reactions. >> SOLOMAN HLASA [Motorbike Instructor]: It's just a matter of giving him a lot attention. >> ISAAC MONOKWA: I had some difficulties changing gears at first. But as I ride more, I'm getting used to it. >> SOLOMAN HLASA: He's not yet confident standing up. >> VOICEOVER: If Isaac can't stand up on the bike, there's no way he'll tackle Lesotho's rough terrain. >> SOLOMAN HLASA: Oh, you can see he's very scared. >> VOICEOVER: But Isaac's determined. He has a very personal reason to succeed. >> ISAAC MONOKWA: I wanted do this work because I discovered I was HIV positive. When I found out, my life became miserable, and back then the treatment wasn't really available. I went for counseling and they were looking for people who weren't ashamed to come out and talk about their status. I turned out to be one of the brave ones and they gave me training. >> VOICEOVER: The weather in Lesotho can change in an instant. Today, Isaac and the other trainees are getting their first taste of riding in the rain and over rough ground. The going's tough for all the riders - but especially for Isaac. >> SOLOMAN HLASA: He comes off the bike but he gets back on very fast. He shows a lot of courage. >> ISAAC MONOKWA: I think it is determination that brought me here. I knew I'd meet these challenges and that I'd fall, but to fall doesn't mean you have to give up. You have to get back on and carry on riding. >> VOICEOVER: Gradually, Isaac starts to get the hang of it. >> SOLOMAN HLASA: So far Isaac has improved a lot, and he's making me proud so far, yeah. >> ISAAC MONOKWA: Today's training was really tough but I liked it. I'm going to sleep like a baby. I'm really tired. >> VOICEOVER: Back at his government health center, and having passed his two weeks training, Isaac's ready to hit the road. >> ISAAC MONOKWA: I'm very excited because this will be my first day. Today I'm going to a village called Gamosethe. I'm going to follow up on patients who I've not seen for over a month. I think they'll be happy because before I wasn't able to get to them, so I think they'll be excited to see me. >> VOICEOVER: And he was right. >> TITLE: ViewChange >> TITLE: Riders for Health, Rockhopper TV, Lesotho >> VOICEOVER: Takiso Setsabi is on his way to one of the seven rural health centers he serves. He's one of thirty sample transporters operating in Lesotho - the missing link between rural clinics and hospital laboratories. >> TAKISO SETSABI [Nurse]: I love riding the bike because it's not here for fun but to help the community. It makes me really proud because there aren't many of us who ride. >> VOICEOVER: At Takiso's destination, Fatima Health Center, the nurse, Tjoloba, is with one of his HIV positive patients. Mamahloli has walked for four hours to get here from her village. The drugs she takes to manage her HIV have been causing her painful side effects, so she's stopped taking them. >> TJOLOBA TJOLOBA [Nurse, Fatima Health Center]: We are going to check kidney and liver function so we can change her drugs to another first line regimen, which has lesser side effects. >> VOICEOVER: The faster Tjoloba can get the results, the sooner he can get Mamahloli back on treatment. He knows that Takiso's on his way, but that wasn't always the case. Before the motorbikes, Tjoloba would have to rely on patients volunteering to take samples to the hospital laboratory, 20 kilometers away, on public transport. >> TJOLOBA TJOLOBA: Previously there was no choice. The samples include the TB bacilli as well as HIV. If anything could happen for the spilling of those samples within the public transport that means every passenger within would be at risk of contracting some infection. >> VOICEOVER: Samples often sat waiting for someone to take them and Tjoloba had to collect the results himself. Sometimes the whole process would take two to three months. It was a delay that cost lives, especially with diseases like tuberculosis. >> TJOLOBA TJOLOBA: TB is very important to get results immediately. While we are still waiting for the results the patient could be infecting other people and we end up with a lot of deaths. >> VOICEOVER: But now, Takiso visits the health center twice a week. Today, as well as Mamahloli's samples, he's collecting blood and sputum from nine people who may have TB. He's been trained how to handle and transport these samples. >> TAKISO SETSABI: Because I ride on these rough roads every day, I know how to handle them. When I get to parts that are really pot-holed, that shake you around, I stand up. In a car, the samples would just be rattling around all over the place. >> VOICEOVER: Many samples used to be ruined by lengthy storage or in transit. But now, Takiso can get to the lab quickly, ensuring the samples arrive in good condition. >> TAKISO SETSABI: I register the samples and I also help with basic laboratory tests because they've taught me how to do that. >> VOICEOVER: A couple of days later and Takiso is returning to Fatima Health Center with the results. And for Tjoloba, there's great news about his suspected TB patients. >> TJOLOBA TJOLOBA: All the results for TB are beautifully negative. >> VOICEOVER: There's good news for Mamahlodi too. The results show her liver and kidneys are functioning well, so she can be given more suitable lifesaving treatment straight away. And for those like her who have to walk so far to get here, the reliability of sample transport means it's never a wasted journey. >> TITLE: ViewChange >> VOICEOVER: Tukula Mothonyana is a TB officer based at Maluti Hospital in Lesotho. >> TUKULA MOTHONYANA [TB Officer]: I run TB clinics here and get people started on treatment. TB is a very dangerous disease because it's so infectious. It spreads quickly and easily from person to person through the air, so it's important to get people on treatment fast. My biggest challenge is when some people default on their medication. Often, they start to feel better, and so they stop taking the drugs believing they're already cured. >> VOICEOVER: Defaulters are common in Lesotho. Often they don't collect their treatment or attend check-ups because it's so difficult for them to get to their nearest health center. Tracing them quickly is vitally important, but finding defaulters can be a major challenge. Experienced rider Mathato, is taking recent trainees and fellow health assistants, Puleng and Lintle to try and track down one such TB patient. The first stop is his local council office. But there's some bad news. >> PULENG: We have just discovered that Mr. Fata Masupa has just passed away already. >> VOICEOVER: It may be too late for their defaulter, but it's still vital they find his family. There's a risk they too might be infected and could be passing it on to family and neighbors. Having been pointed in the right direction, they set off. But with no road names or house numbers, it's never that simple. >> MATHATO [Nurse]: It seems that there are two people with the same name and surname so this one is not the one we are looking for. The one that we are looking for is that one down there. >> VOICEOVER: A case of mistaken identity, so the search continues. But sometimes, patients deliberately give false details to health workers, as Tukula knows all too well. >> TUKULA MOTHONYANA: It makes it really difficult when some of them give us false names and addresses. When you want to visit them you go to the village and find no one knows them. >> VOICEOVER: But why don't they want to be found? Well, health workers Lesotho always encourage patients to get tested for HIV so they know their status. But many people here just don't want to know. Back with Mathato and her team, and they've managed to find the widow of the deceased defaulter. >> WOMEN: So sad to discover that the person we are tracing is dead. And she's still mourning. >> VOICEOVER: They suspect that by defaulting on TB treatment the dead man may have developed a more dangerous strain known as Multidrug-Resistant Tuberculosis, or MDR TB. >> WOMEN: The family, they might be infected, we don't know but we advised her to go for the checkup. >> VOICEOVER: This constant vigilance is what's needed to keep this dangerous strain of drug resistant TB contained. >> TITLE: ViewChange >> VOICEOVER: Across Lesotho, motorbikes are constantly ferrying medical samples from clinic to lab, or allowing health workers to reach the communities they serve. These services rely on their bikes day after day. But keeping them going on these tough tracks is no mean feat. In charge of keeping Lesotho's fleet of a hundred and twenty motorbikes on the road, is mechanic Thaele Seleke. >> THAELE SELEKE [Motorbike Mechanic, Lesotho]: A bike is a small thing; it's not like a car. A car can last a bit longer. But really when you look at this machine it needs you to take care of it just like a baby. Watch it closely. I've got 120 babies here to watch. >> VOICEOVER: If any of Thaele's 'babies' need serious attention - a new clutch, a set of shock absorbers or a major engine problem - he brings them here to the workshop. But most of his time is spent out visiting the bikes all over the country. >> THAELE SELEKE: It's all about preventing problems from happening. We detect them before they can happen. It's unusual because we are the only ones who are doing this kind of job here. >> VOICEOVER: This preventative maintenance is what sets Thaele and his team apart. >> THAELE SELEKE: We always do this as a routine each and every month. Check everything, service everything; make sure that it's tip-top. >> VOICEOVER: Vehicles all over Africa are in a terrible state. At hospitals, you'll often find vehicles, some nearly new that are left rusting because of a blocked air filter or a worn out tire. But Thaele and his team go that extra mile to make sure they spot and fix problems before the bikes break down. With eight bikes to get through, there's no time to waste. But Thaele gets all the riders involved. >> THAELE SELEKE: I do like very much when I work on someone's bike. The rider should be there so that we should discuss few things. I always pass my knowledge to them. >> THAELE SELEKE: What you're doing isn't right. You have to have a tape, so you know the exact measurements - about 30 millimeters. >> THAELE SELEKE: The small things - they should know how to check them on their own. >> VOICEOVER: They're all trained to do daily checks. But it's not just about keeping the bikes running. >> THAELE SELEKE: If you don't do a check you before you ride, really you are risking your life because it might lose things like bolts, or chain warn out then when it cuts off really you fall off terribly. So we make sure we prevent such things. They shouldn't happen. >> TITLE: ViewChange >> TITLE: Riders for Health, Rockhopper TV, Lesotho >> VOICEOVER: Lesotho has the third highest HIV prevalence in the world. Almost one in four people here are living with the virus. But Lesotho is fighting back and HIV counselors like Lefulesele Masokanye are in the frontline. Today she's come to St. Magdalena rural clinic. Much of her work involves trying to prevent mother to baby transmission of HIV. She's here to follow up on those suspected of defaulting on treatment or missing checkups. >> LEFULESELE MASOKANYE [Mentor Mother, Berea District, Lesotho]: I have got the list now for the people we are visiting today and the first one is a pregnant woman and she's positive. So we are going to look if she has already taken the drugs to prevent the virus to pass through to the baby. >> VOICEOVER: A lot of Lefulesele's time is spent out in the villages, encouraging pregnant mothers to attend check ups and get treatment. If they're put on prophylaxis early enough in pregnancy, there's a very good chance they won't pass HIV to their babies. But it can be a difficult job persuading people who live so far from the clinics. >> LEFULESELE MASOKANYE: When they get home they don't take it seriously. That's why we have to follow to see that they're doing the right thing. >> VOICEOVER: Lefulesele has come to see Mamojaki and her three-month-old baby girl. But soon after arriving, she realizes there's bad news. >> LEFULESELE MASOKANYE: Her mother didn't get prophylaxis at all. And even the baby didn't get it after she has been born and so the baby could be positive. >> VOICEOVER: Mamojaki says she didn't go for check ups because she's afraid people would shun her if they knew she was HIV positive. It's something Lefulesele comes up against all the time, and she understands it better than most. She's also HIV positive. >> LEFULESELE MASOKANYE: We have to tell everybody, because we have been through this so we have to stop this. I stand there, I tell them that I'm HIV positive, look at me; you can see I'm still healthy. I just tell her she should go there, don't be scared of the people. This is her life, and life comes once, and the treatment is free. She's not going to pay anything. >> VOICEOVER: Cases like Mamojaki's are very close to Lefulesele's heart. They're the reason she does this job. >> LEFULESELE MASOKANYE: I was pregnant so I went to the clinic. I found that I'm HIV positive so they said I should come back and do my checkups but I didn't go. >> VOICEOVER: Lefulesele had a baby girl. She didn't return to the clinic until a month after she was born. It was during that visit that she was asked if she'd consider working as a HIV counselor. >> LEFULESELE MASOKANYE: I heard about an interview for the mothers who are positive, so I went there and I passed the interview. But I didn't realize that when I was holding her she was already dead. I found out when I got home. >> VOICEOVER: Her baby daughter had died in her arms at just one month old. >> LEFULESELE MASOKANYE: I had a very nice girl and I miss her a lot. >> VOICEOVER: A few days later, and Lefulesele has come to check up on Relenbonile, another HIV positive mother. But today's not a nice day to be out on a motorbike. >> LEFULESELE MASOKANYE: It is very bad today, very bad. All of a sudden hailing, sunshine, cold at the same time. Even lightning! >> VOICEOVER: But for Lefelesele, it's all worth it. Relenbonile has been to all her check ups. She's taken the treatment throughout pregnancy, birth, and through to weaning. Her baby's recently been tested and is HIV negative. http://www.viewchange.org/videos/zambia-seeing-is-believing <p>Many people in Zambia don't consume enough vitamin A, which leads to blindness, infant mortality, and a host of other health problems. However, the Zambian government has initiated programs to ensure its people receive the nutrition they so desperately need.</p> Mon, 18 Oct 2010 08:49:00 +0000 http://www.viewchange.org/videos/zambia-seeing-is-believing Nutrition, Zambia, Vitamin A deficiency, Lusaka, Luapula Province, Health, Agriculture & Food, Journeyman Pictures, UNICEF, Africa >> VOICEOVER: On Lake Mweru, in Zambia's northern Luapula Province, fishermen are bringing in the day's catch. But, for local people, a plentiful diet of fish has had unexpected consequences. A survey showed that 57 percent of blind people in Zambia come from Luapula Province. The cause: lack of vitamin A, a lethal public health problem, which also has a significant effect on child deaths, as well as increasing the risk of women dying in childbirth. >> TITLE: Seeing is Believing >> VOICEOVER: On the shores of Lake Mweru, Dr. Kunda runs a child health clinic serving the fishermen's families. >> DR. SIMON KUNDA [Kabuta Rural Health Centre]: People here regard fish as the only nutritious type of food, so they deprive the children of other foodstuffs, giving priority to fish. Dietary supplements are so low. Most of the mothers go for fieldwork in the morning. They come back very late, so feeding is compromised. We usually detect that when there is diarrhea, and when a patient comes with eye problems, that's when we see that surely there is a vitamin A deficiency. The impact of vitamin A deficiency, it has brought in high mortality and morbidity. We need to encourage these mothers to be giving their children vitamin A supplements. As you can see, if you look at the conjunctive of the child, it's very, very red. So, measles also affects the eye, so it's very easy for these children, especially if they are malnourished, to get blind. >> VOICEOVER: In Zambia's capital, Lusaka, Freddy Mubanga is responsible for increasing vitamin A intake, both in Luapula Province and throughout the whole country. >> SIGN: The National Food and Nutrition Commission >> FREDDY MUBANGA [Acting Executive Director, National Food and Nutrition Commission]: We started investigating the micronutrient deficiencies in 1985, when we undertook a survey in one of the provinces, Luapula, which had recorded high levels of blindness. It was found that about 16.2 percent of children 6 to 72 months had subclinical vitamin A deficiency. That, of course, gave way to start thinking of some strategies to see how we can reduce the levels of deficiencies. >> VOICEOVER: Since the 1995 survey, Zambia has implemented vitamin supplements for children at child health clinics, both throughout the country and in the capital, Lusaka. >> SIGN: George Clinic: Family planning services available here. >> NURSE: George has got a very big catchment area, and we see a lot of children. It's a really highly populated place, and it's a very busy clinic. We have a lot of underweight, malnourished children. We give vitamin A to the under fives. >> WOMAN [Mother]: I think for my baby to be healthy, I need to be coming here to get medicine for her to be protected from various diseases. Breastfeeding's the best, and it's cheap, very cheap. You can buy vegetables. You eat. When the baby feeds, she gets all the nutrients. It's very cheap, in fact. I like it. >> NURSE: Five or six months? >> WOMAN 2 [Mother]: Five. >> NURSE: Yes, they can get it through breastfeeding, yes. In case they don't get enough through the foods, then we supplement at the clinic by giving you vitamin A capsules. >> FREDDY MUBANGA: Following the national survey on Vitamin A deficiency in 1997, we realized that the problem is so immense, so we have to look at other options. In addition to supplementation, we thought of moving into sugar fortification. We looked around [at] what food vehicles we can use, and sugar seemed to be the one that was produced centrally, and it was found in almost every part of the country. >> VOICEOVER: To add vitamin A to sugar, the government needed the cooperation of Zambia Sugar, a private corporation and the country's sole producer. >> JAMES MUKUKWA [Production Manager, Zambia Sugar]: It was a program that was introduced by the government to the industry, so it was very new to us. We knew literally nothing. People working with the government, they had contacts in Guatemala who were really the founders of VA fortification of sugar. So the best way to undertake that project was to go to the source, to the experts, and me being the production manager, I had to go there because eventually I had to come and implement that project. Zambia Sugar agreed to help out with the national health problem that the whole country faced as a sign of goodwill, so it's actually doing it for free. The company bears the cost. It's very expensive: every year, we spend almost USD$1 million to buy the VA, the vitamin A. >> VOICEOVER: USAID has also been a major supporter, and initiator, of the sugar fortification program. >> JAMES MUKUKWA: Since we implemented the fortification program at Zambia Sugar in 1998, we've had several delegations coming from other countries: Uganda, South Africa, Malawi, and Kenya last year. They've been here to inquire and familiarize themselves with the VA fortification, with a view of them also going the same way. >> VOICEOVER: It may cost USD$1 million a year to fortify all of Zambia's sugar with vitamin A, but the cost per bag of sugar is just a few cents. And even that pales into insignificance when you add in the number of lives saved and the huge health benefits of vitamin A fortification for all Zambians. >> FREDDY MUBANGA: Last year actually the Zambian government passed regulations to say all the sugar that has to be consumed in households has to be fortified with vitamin A. Since we started enforcing that, the border areas -- Zimbabwe, Namibia, Botswana and so forth -- their sugar is still coming in. So it becomes a bit difficult to enforce, or to control, the influx of this. But all the sugar that enters through the border points, it has to conform to the regulations. >> SIGN: Customs and Immigration: Entrance >> CHILUBA MWAPE [Plant Health Inspector, Chirundu Border Post]: This is brown sugar coming from Zimbabwe. Now we've got one truck carrying sugar, brown sugar, 30 metric tons. Yes, from Zimbabwe. When the truck comes which is carrying sugar from Zimbabwe or South Africa, we take samples. When we get these primary samples, we submit them to Lusaka for further analysis at the food and drugs laboratory. >> SIGN: Ministry of Health Food and Drugs Control Laboratory, Lusaka >> MRS. SONGOL [Food And Drug Control Laboratory]: We have the food and drugs regulations, where the levels of vitamin A in sugar are stated. So we make sure that, from the analysis, we check whether the levels do conform to the standard. We receive the samples form all over the country. We also get samples from Zambia Sugar company itself. Part of their quality control program is actually to bring the samples here for analysis. We discovered that some samples of sugar were actually indicating that there was no vitamin A, but when they were analyzed at the factory, they were finding some vitamin A. But after storage the levels of vitamin A were going down, until at one point we were finding actually zero. From that time on, there's been regular sampling to make sure that that problem does not occur again. We have to keep on checking on the quality of food, because we can't relax and say, "Well, since we've been testing so far, maybe now we should stop." No, it's an ongoing process. ++++1154 >> VOICEOVER: Although fortification of sugar has been a success in Zambia, it reaches only 52 percent of the population in comparison to Zambia's staple food, maize, or mshima, which is consumed by over 90 percent. >> FREDDY MUBANGA: We felt that probably we need to diversify the food base for fortification, and one sort of food that we thought of was maize, because it's highly consumed in Zambia. >> VOICEOVER: In Lusaka's Chawama township, government scientists are testing the adding of vitamin A supplements to maize at the local Hammer Mill. Unlike sugar, which is produced at one single source, 40 percent of maize produced in Zambia is ground in local mills used by people in poor urban and rural areas. Simple methods had to be found to ensure local people would mix vitamin A into their own maize meal. While Zambia has expanded fortification of foodstuffs with vitamin A, evaluating its impact can be difficult. >> WARD SIAMUSANTU [National Food and Nutrition Commission]: It's ideal to do the impact study now because the baseline was there in 1997, and now it's almost like six years. We could actually find what has been happening. However, we have malnutrition levels very high. We have HIV problems we're going through. It will be very difficult actually to tease out which component has vitamin A supplementation has actually affected in our population. It's very difficult because the amounts that are put in sugar are very minimal, so you need to, at the same time as you are looking at fortification, you have also to look at dietary levels, which might take longer. It's one of the most important things to follow. Let's change our people's diets so that we don't even bother fortifying, supplementing. From the diet they could eat, you could have a lot of vitamin A. >> VOICEOVER: Back in Luapula Province, nutritionists are working on improving people's diet and preventing future cases of blindness, illness, and death. >> DON KAYEMBE [Provincial Nutritionist, Luapula Province]: Even us as nutritionists, we are promoting that you can take fruit, you can take vegetables, for vitamin A, but as long as there's no presence of oil, so it can't be absorbed by the body. These palm oil trees are imported by the producer from Costa Rica. We brought them because naturally they are along the Luapula Valley, we have got the traditional ones, so those ones are not bearing much fruit, and even the fruit which are received are not giving us as much oil as expected. So these improved seeds, they are helping to give us more and more cocoa oil from one bunch. When they grow, after at least one year, when they become like these ones, we start now giving out to the communities. Now, the communities, there are some who are accessing them at very low cost, just to promote this and to give them ownership. So far I think we've distributed 57,000, and what we've imported so far could be 65,000 or so since we started in 1997. >> VOICEOVER: It takes four years for the palms to bear fruit. In local villages women have been learning how to make palm oil. Mrs. Eskembene of Sensima Village was sent to Ghana to study palm oil production. >> MRS. ESKEMBENE: We used to process palm oil before, but for no particular reason. Sometimes people would use it, others not. But, after we knew the benefits of it, we decided to increase production. >> DR. STELLA GOINGS [UNICEF Representative, Zambia]: Zambians were quick to realize that vitamin A deficiency was contributing to an intolerably high rate of morbidity and mortality, especially for children, and they were also quick to understand the importance of supplementation, fortification, and diversification programs. Zambia is a country that is confronting a food crisis this year. This is forcing [the] government to reconsider the way they look at food and the way they handle food. A part of this -- we hope that UNICEF will play a very active role -- will be making certain that mothers and people who are in charge of preparing food for the household are equipped to establish and maintain household gardens, and that we provide the education that's necessary for ... so they know how to prepare the foods. >> VOICEOVER: Back at Dr. Kunda's clinic, mothers are now taking cooking classes to learn how to prepare vitamin-rich foods. >> DR. SIMON KUNDA: We've started a program where we encourage mothers to be using the local variable foods, like green vegetables, yellow fruits like pawpaw, oranges, and here, we are lucky because we have these palm trees. Now, research has discovered that these things are very rich in vitamin A, so we encourage mothers to be using the oil from palm trees. >> VOICEOVER: For the people of Luapula Province, adding vitamin A to their fish diet now promises a healthier, brighter future. >> TITLE: [end credits] http://www.viewchange.org/videos/dorah-s-story-loyalty-through-quality-care <p>Dorah Nyanja runs a micro-franchise clinic in Kibera, a slum of Nairobi. She works 14-hour days to serve a community that desperately needs her, and she has found satisfaction in her work that equals the relief her patients receive from her.</p> Thu, 02 Sep 2010 01:23:00 +0000 http://www.viewchange.org/videos/dorah-s-story-loyalty-through-quality-care Kibera, Health, Acumen Fund, Nairobi, Community development, Clinic, World Health Day, Kenya, Africa, International Women's Day >> DORAH NYANJA [Doctor, Sustainable Healthcare Foundation, Nairobi]: We want to weigh the baby. Okay. Five point two kilograms already. Five point two KGs for a 10-week-old baby? Good enough. >> INTERVIEWER: He's good? He's a healthy baby? >> DORAH NYANJA: Yes, this is a healthy baby. As a businesswoman in Kibera, the challenges are enormous. One, I'm in business, yet I'm in business in a community which is very poor. >> TITLE: This is the story of Dorah Nyanja, a Sustainable Healthcare Foundation (SHF) franchisee in the Kibera slum of Nairobi, Kenya. >> TITLE: SHF uses a micro-franchise model of clinics to increase access to essential medicines. >> DORAH NYANJA: This is a slum area. The area is densely populated. People are poor. Most of them live on less than USD$1 a day. Sanitation here, it is quite compromised. The prevalence of diseases like tuberculosis is very high. When something like meningitis strikes, it spreads very fast. You can imagine, if you cannot afford the basic needs, like shelter or food, at the end of the day, how will you afford healthcare? And that is where people like us come in. We try and tell them, "You can have quality care at an affordable fee." They know, once they come and pay, then I'm accountable for their health. If they go for free service, whether they get better or not, no one is accountable. SHF keeps me on my toes because I know I have to maintain standards. The clinic has to be absolutely clean. The drugs have to be of the right standards. >> DORAH NYANJA: Initially, I was seeing about 30 patients a day, but when they realized this is a professional who is here, and she is ready to help, the number started increasing. From 30, I went to about 50, 60. Now, I end up seeing even 100 patients in a day. You have to go out and market yourself, yeah? I've gone out. I've gone to schools. I've gone to the women groups. I've gone to the churches. I've gone to the chiefs of barazas [local councils]. The way you relate to the community also plays a big, big role. I put in more than 14 hours every day. I don't live around here, I live 20 kilometers from here, and I have to take public transport from home to the clinic and back every day, so it becomes quite challenging. What keeps me going at the clinic is that the patients appreciate the service that I give to them. Money plays a big role in life, but it is not everything. Some of us have a lot of money, but they are not happy. But I'm making much less, but I'm a happy person, because I know I'm giving service to a community which deserves to be given quality care. http://www.viewchange.org/videos/mdg-4-reduce-child-mortality <p>With Australian support, more birth attendants are being trained in rural and remote parts of Papua New Guinea, helping to reduce infant deaths.</p> Tue, 24 Aug 2010 20:42:00 +0000 http://www.viewchange.org/videos/mdg-4-reduce-child-mortality Child, Millennium Development Goals, Health, Rural area, Mortality rate, AusAID, Papua New Guinea, Kokoda Track, Healthcare, Clinic >> TITLE: Millennium Development Goals (MDGs) >> TITLE: 4. Reduce Child Mortality. The death rate of children under five has declined steadily from 12.6 million in 1990 to 9 million in 2007. But the rate is still too high -- one death every 3 seconds, mostly from preventable causes. >> TITLE: Target. Reduce by two thirds, between 1990 and 2015, the under-five mortality rate. >> TITLE: Papua New Guinea. >> VOICEOVER: Often one of the challenges in reducing child deaths is reaching the large populations that live in remote areas. So health teams like this one in Papua New Guinea trudge for hours on muddy tracks through mountainous countryside to set up health clinics in villages like this one in Kanga, not far from the Kokoda Track. >> LEON SIME [Health Action Officer]: My work in here, being a health action officer, we were trained especially to work in the rural areas, like a doctor that does clinical duties in the hospital, we do the same in rural areas. That includes the family health and immunization patrols, doing family planning, antenatal care, I coordinate that within the health center. >> VOICEOVER: Village volunteers are also trained to provide basic medical assistance and advice. >> LEON SIME: They have also been trained to identify and refer those cases to the health centers and hospital for treatment, and also they've been trained to do antenatal care for mothers who are pregnant and they can estimate the date of birth and refer them in, encourage mothers to come in for deliveries in here. >> VOICEOVER: Better access to healthcare, immunization, and education are keys to keeping children healthy. >> MICHAEL LUCAS [Kanga Village Chief]: When health program is an educational program like this, trying to educate people, I think that will help us, will change our living and also people will change from when they're young, too. >> TITLE: What is Australia doing? Training more skilled birth attendants in rural and remote PNG to help reduce infant deaths. Increasing births supervised by skilled staff is an important focus of the PNG-Australia Partnership for Development. Working with governments and other donors to improve the supply of vaccines and immunization globally. http://www.viewchange.org/videos/the-chance-to-save-millions-a-bold-new-endeavour <p>Across Africa, millions of adults and children die every year from treatable diseases. Sometimes all that is needed is one shot or a single pill. But with the vast majority of Africans living in remote areas, the question is how to get these potentially life-saving treatments to the sick? A bold new endeavour empowering members of local communities to help each other may just be an answer.&nbsp;</p> Tue, 06 Jul 2010 23:36:00 +0000 http://www.viewchange.org/videos/the-chance-to-save-millions-a-bold-new-endeavour Africa, Onchocerciasis, Blindness, United Nations, Ivermectin, Clinic, Vaccination, Immunization, Parasitic worm, Infectious disease >> DALJIT DHALIWAL: Across Africa, millions of adults and children die every year from treatable diseases. Sometimes all that is needed is one shot or a single pill. But with the majority of Africans living in remote areas, the question becomes: how to get these potentially life-saving treatments to the sick? A bold new endeavor may just be an answer. >> VOICEOVER: No, this is not a political rally or a religious gathering. It is an innovative new way to deliver health care in remote, African villages. Begun almost 15 years ago with one disease and one drug, this community-led process is now being explored to deliver much more, for more diseases. But let's start at the beginning, in one of many small villages in Nigeria, where Esther is trying to make a living selling cassava. Money isn't her only problem. There are numerous diseases that are always a risk: like malaria, which kills mostly children and pregnant women; and a parasitic worm that damages the skin and eyes causing terrible itching and, in the worst cases, blindness. When she was younger, Esther was infested with the parasite. >> ESTHER: My father actually went blind from this disease. I was afraid that I would lose my sight as well. >> VOICEOVER: This disease is called onchocerciasis, or river blindness, because the black flies which spread the parasites to humans breed in rivers and streams. River blindness affects 30 countries in Africa alone. The World Health Organization estimates that half a million people are blind because of it. Fortunately, there is a drug which can prevent the disease. But getting Ivermectin to all the people who need it is a massive task. A radical new method of drug distribution was needed, a method that would work in the demanding conditions of rural Africa, where there aren't enough doctors and nurses to serve in these remote areas. So it was decided to unite rural people living here to do the job themselves. Cleophas Bakari is one of these volunteers. He's a Community Drug Distributor for his village, Garbachede. Cleophas isn't just liked by his community, he was chosen by them. That's essential to the success of the program, says Professor Oladele Akogun, local Research Coordinator for the project. >> PROF. OLADELE AKOGUN: It is absolutely important and it is actually the foundation of community participation because they need somebody they trust, somebody that reports to them, somebody that obeys and agrees with their culture. >> VOICEOVER: Community meetings like this discuss and decide on all aspects of the Ivermectin distribution program. Today, they are reviewing how well the distribution went this year. This man complains that households near him didn't get any Ivermectin. A representative from the health clinic asks him to be more specific: who missed out and where? The volunteers are trained by local, qualified medical staff and are carefully followed by research scientists and the African Programme for Onchocerciasis Control. At first, the professionals were skeptical that unqualified and often uneducated villagers could carry out drug distribution correctly and safely. >> DR. HANS REMME: You give a drug to a community they will kill everybody, they will sell the drug, it will be a mess. >> VOICEOVER: Tropical Disease Research Coordinator at the World Health Organization, Dr. Hans Remme. >> DR. HANS REMME: So we did some first studies to find out and address that question, and the answer was communities had no problem whatsoever of doing this. They were very good at it. Actually, they took it very seriously. >> CLEOPHAS BAKARI: At first I had doubts about it. But later when I went for the training, and as the training went on, I learned that I could do the job well. >> VOICEOVER: Sixty million Africans are now being treated for river blindness by volunteers like these in four different countries in Africa. But now they have been asked to take on a much bigger challenge: treating up to five different diseases, including malaria, which kills more than two and a half million Africans every year. Esther is now a fully trained community drug distributor. She wants to help those who suffer most from malaria: pregnant women and children under five. Just then, Esther's neighbor arrives. She's very concerned about her baby, who's got a high fever. The mosquito bites are worrying. Fortunately, Cleophas has been trained not only to prevent malaria but also to diagnose and treat it. >>PROF. OLADELE AKOGUN: They mainly use symptoms. The CDD touches the head to compare the temperature of the head with his own and see the difference in temperature, and that tells you that this child has fever. About 90 percent of every fever case is malaria in Africa. >> VOICEOVER: The treatment is very straightforward: Coartem, a combination therapy which includes the most effective anti-malaria compound, artemisinin. But it's vital it's taken as soon as possible. That's why Esther wanted to be trained. At home and in the market, she's always available when mothers and their children need help. Esther now keeps a stock of Coartem in her own home so neighbors can come for anti-malaria drugs day or night. A three-year study just released shows that community drug distributors like Esther are having a huge impact. >> DR HANS REMME: The results were really dramatic. We found without this community pressure the cover, say, for proper treatment for malaria was around 20 percent of the children. With this approach we jumped to 50 percent. >> VOICEOVER: The volunteers are keen to take on more and more responsibility. >> ESTHER: We live in a very remote, rural area and there are so many diseases here which affect us. So, if more interventions are introduced, we will have fewer sick people in the community. >> VOICEOVER: The challenge now is to see whether other communities across Africa can achieve the same success. >> DALJIT DHALIWAL: That's all for this edition of 21st Century. I'm Daljit Dhaliwal. We'll see you next time. Until then, goodbye. >> TITLE: 21st Century a production of United Nations Television Department of Public Information